Health care costs represent a significant portion of the economic activity of the United States and continue to rise at a faster rate than the inflation rate of the overall economy. A contributing factor of the ever increasing health care costs is pharmacy care costs, which are increasing even faster than the health care costs. In order to reduce the costs of care, physicians have been under increasing pressure to be more efficient in patient care. In the area of the pharmacy care, this means physicians are required to understand and analyze a patient's pharmacy care history completely and efficiently.
There have been a number of proposed approaches in presenting patient pharmacy care history to information physicians. One such conventional system using a computerized system, a prescription creation screen 39, is illustrated in FIG. 1 and described in U.S. Pat. No. 5,845,255 to Mayaud incorporated herein by reference. The creation screen 39 includes an array of buttons that can be activated by a user (e.g., a physician). In discussing various buttons of the prescription creating screen 39, near the top of screen 39 is a patient features bar 40 below which a prescription features bar 42 coordinates features necessary to review current therapy and order changes in treatment, or to order new treatment, for a selected patient. A prescription history zone 43 extends across the middle of the screen, the lower screen portion contains a prescribing zone 44, and a screen title 45 appears at the top of the screen.
Patient features bar 40 comprises a Select Patient button 46, a selected patient indicator 48, in this case Mary Harrington, a patient Problems button 50 and a patient Allergies button 52. Beneath Problems button 50 are displayed Mary Harrington's currently active problems 51 or conditions, shown here as pharyngitis and bronchitis. Beneath Allergies button 52 are displayed Mary Harrington's known allergies. Pressing or otherwise activating Problems button 50 or Allergies button 52 access a remote database for the patient's history and, opens a window or screen listing problems or allergies from which a physician, or other professional users, can select new problems or allergies to add to Mary Harrington's record, or delete ones that are no longer active. Optionally, system-provided problem or allergy libraries may be organized into multiple lists with button 50 or 52, respectively, opening a list selection box as a preliminary to displaying a selected problem or allergy list.
Prescription features bar 42 comprises an Rx History button 54, an Rx Options button 56, an Updating indicator 58, an Rx Info button 60 and a Renew Rx button 62.
Prescription history zone 43 displays those historical prescription details that may be relevant to a current prescription and has a Condition field 64, a Drug field 66, a Size field 68 a Dosing field 70, a generic flag 72, an Expires field 74 and a Mine field 76, in which the various characteristics of patient Mary Harrington's previous prescriptions are listed.
Prescribing zone 44 comprises three active buttons, New Rx button 78, Send Rx button 80 and Close button 82, below which extends a prescribing header bar 84 which contains field identifiers for data entry of a full complement of prescription details. Available prescription detail fields comprise a Condition field 86, a Drug field 88, a Generic field 90, a Form field 92, a Size field 94, a Route field 96, an Amt (Amount) field 98, a Refill field 100, a Dosing field 102 and an Expires field 104.
Multiple lines of the selected patient's prescription history are listed in patient history zone 43 in the middle of the screen for review by the physician-user, and possible renewal, with scrolling or paging of extensive histories. Depending upon the patient's previous whereabouts and service providers, individual lines may come from multiple remote sources.
Prescribing zone 44, lowers down prescription creation screen 39, allows a physician user to select and prescribe drugs and dosages, for the selected patient, in this case Mary Harrington, and to transmit the created prescription by activating the Send Rx button 80, externally across a data network to other interested and authorized parties for prescription fulfillment block 55, patient record updating arrow 57 and the like. Send Rx button 80 can also output the prescription to print or storage.
Select Patient button 46 brings up a patient selection screen for selecting a different patient from one or more lists. Select Patient button 46 draws up a “Today's Patients” list or whichever patient list the user last selected from, or a default, user-selected patient list, and provides the options of selecting a new patient from alternative patient lists.
Problems button 50 brings up a patient problem history information screen in which a historical record of the patient's individual symptoms and diagnoses is listed and to which new problem reports can be posted. To maintain data integrity, and as a legal safeguard, historical information is not editable but may be supplemented, for example by reporting the subsequent status of a problem as (still) active or inactive. Any such additions to the record are stamped with the identity of the reporting physician, providing valuable elements of a treatment decision-making audit trail.
The patient's drug-related allergies, or drug reactions, are brought up in possibly editable form (screen not shown) by activating an Allergies button 52 and may be automatically updated, if desired by adding newly reported drug reactions and allergies, arrow 51. Desired personal or drug records relevant to possible allergies of this patient may be summoned from a host computer facility, which may in turn call on a remote database data-retrieval network block for records or record elements.
Rx History button 54, scrolls, drops down, or otherwise accesses any additional patient history lines beyond what will fit in prescription history zone 43 and may introduce vertical or horizontal scroll bars, or both, into zone 43, enabling the user to display any desired section of a patient's prescription history in zone 43 with the top line of the history highlighted. Any desired prior prescription line displayed in zone 43, can be highlighted by clicking or pressing on it.
A highlighted prior prescription can be automatically renewed by clicking or pushing a Renew Rx button 62. Typically, prescription creation screen 39 opens with the most recent prescription highlighted for possible renewal. Activating Renew Rx button 62 posts a highlighted prior prescription into prescribing zone 44 for automatic renewal, after editing, if desired. Renewal of any prior prescription can thus be effected in as few as two user steps by pressing Renew Rx 62 to post a highlighted previous prescription to prescribing zone 44 and completing a prescription in a single step from there. If desired option buttons such as Renew and Send Last Prescription or Renew All Active Prescriptions can be added. Pressing header buttons Condition 64, Drug 66, or Expires 74 causes the drug history display to be sorted by the selected header enabling the prescription history to be evaluated according to a particular parameter.
Because prescription creation screen 39 is complex and elaborate, a physician must invest time to learn and use it. Should there be more than one type of screen (e.g., each insurance carrier may have its own screen), the physician has to invest more time to learn them all. Due to these and other shortcomings, instead of assisting physicians in streamlining their practices, the conventional computerized systems may actually cause the physicians to be inefficient. FIG. 2 is an illustration of a conventional computerized system requires a physician to purchase/license not only software packages to run the screen(s) but other communication equipment as well.
In particular, the left hand side of FIG. 2 shows an arrangement of services and devices that provide a downstream flow of data and communication resources to users of the conventional system. The right hand side shows sources from which desired data and data elements may be drawn and pathways for those data to reach the user. The flow is marshalled by a centrally depicted host computer.
Shown schematically in FIG. 2, are a number of user interface devices 200 and a desktop computer 201 communicating via any of a variety of communication services 202, through a gateway-router 204 with a host computer facility 206. FIG. 2 depicts schematically how a group or pool of users working with interface devices 200 or computers 201 running the screen 39, can be serviced by host computer facility 206.
Interface devices 200 are depicted as small form factor, handheld devices, or PDA's, communicating wirelessly over a WAN, a proprietary wireless service, or a cellular digital packet data service, or the like. Desktop computer 201, which may be a portable, notebook or other higher form factor computer, connected to communications gateway-router 204 via a local area network labeled LAN.
As shown above, the conventional computerized system requires physicians to purchase computer(s) and communication equipment, which may be different for each insurance carrier, in order to communicate with host computer facility 206, which may also be different for each insurance carrier. This requirement, rather than assisting physicians in understanding and analyzing patients' pharmacy care history, may actually hinder such activity and impose additional capital expenditures on physicians.